| NPI | 1225440852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME136110) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL36894) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2020-01-09 |